Joanie Selman, MSN, RN
Med-Surg Course Coordinator
DeWitt School of Nursing
Stephen F. Austin State University

DeWitt School of Nursing at
Stephen F. Austin State University
Nacogdoches, Texas
Joanie Selman, Med-Surg Instructor

9,000 square foot simulation lab opened Jan. 2010
*10 room Med-Surg lab
*4 room OB/pedi lab and Nursery
*ER with 12 gurney spaces
*Assessment lab with 10 exam tables
*14-station control room
 5-3Gs, 1-SimMan, 1-SimNewB,2-SimBaby,
17 VitalSims, 6-Virtual IVs, SimMom,SimKid






Many schools competing same clinical sites/times
Limited cases in smaller hospitals



Few deliveries
No NICU
No neuro, head trauma
Faculty shortage, students/instructor
No patients with diseases you want your students to experience

Up to 30% of students are Tactile/Kinesthetic learners.
Simulation Enhances Learning

Lecture is not enough, Reading is not enough

Case studies are not enough






Practically All
Collaborate with other courses
Basic courses in beginning semester(s)

Health assessment

Basic Med-Surg

Pharmacology
Scenario……..Elderly man s/p surg after he fell and broke his hip needs assessment of surgical incision, inhaler, repositioning, IS, PO antibiotics and teaching about proper protein intake for proper healing.


Mid-way Courses

OB/PEDI

Med-Surg

Mental Health
Scenario…. Schizophrenic pregnant woman with a 2 year old child brought to ER after a
MVA. She has a broken leg and is awaiting surgery.


Last semester courses

Critical Care

Community Health

Leadership/Management
Scenario…..Shortage of nurses in ICU, manager must delegate & prioritize pt assignments then take the most critical patient herself for the day. s/p major stroke with paralysis and concussion from fall. Wife has meeting with home health nurse to discuss at home care after discharge.


If you can only do limited simulation….
Med-Surg and Pedi/OB courses are your best bet b/c you can incorporate concepts from other courses into the scenario.


Laerdal

Conferences

Book

Visit other schools






Get ideas from others
SIRCSimulation Innovation

Resource Center http://sirc.nln.org/
SUN website
 http://www.laerdal.com/us/SUN
NLN scenarios
Scenarios from textbook publishers
Case studies
Simulation in Nursing
Education
Author:
Pamela Jeffries

Start simple. Do not overwhelm yourself.

Only one scenario the first semester you start

Common scenario from your practice.


Choose problem that is it crucial students know
Not readily available in your area




Assignment to complete on topic before the sim
 article in a journal
 case study

Worksheet

“dress rehearsal” with other students or faculty


Make room and mannequin as realistic as possible

Pre-brief students
 a learning exercise not a punitive evaluation
 act exactly like a real life setting
 give them report – like at a hospital

Give a few minutes after report for them to plan as a team before starting scenario

As mannequin voice give “hints” if student is really struggling.


De-brief immediately

Identify gaps in knowledge

Praise students for positive interventions

Redirect students away from poor choices.

Post-scenario assignment to
 re-enforce clinical concepts covered
Care plan

Assessment values with nurse notes

Taking and writing telephone orders on order sheet




 present a video-taped scenario

Have students share their experience

Discuss the benefits





Teamwork
Delegation
Communication
Decision-making
Time management
 Critical thinking
 Med administration
 Infection control
 Assessment
 Physician orders



 meet with the team have them “attend” one of your simulations.

Offer to assist them in developing a simulation.

Tell them you will “run” the first one with them

Share your ideas, forms, etc

General for all scenarios
Example…Student demonstrates appropriate infection control techniques.
….Student identifies client with two
Specific for individual scenario
Example….Student assesses blood pressure before administering nitroglycerin tablet.


Faculty Objectives for SIM
Failure rate will decrease .
Does SIM help students learn the important concepts in my course?
Since SIM the failure rate in the Med-Surg I teach dropped from an average of 10% to 6%.

Very important to survey the students
Question Disagree No opinion Agree
1. I understand the purpose and objectives of the simulation.
2. The scenario(s) resembled a real-life situation.
3. The simulation provided a variety of ways to learn the material.
4. I had a chance to work with my peers during the simulation.
5. The simulation helped me learn to prioritize.
0.00%
1.33%
0.00%
0.00%
0.00%
6. The debriefing session was helpful as a learning activity.
1.33%
7. I was able to participate in the debriefing session.
8. The feedback was constructive.
9. The simulation will help me better care for healthcare clients.
10. The simulation made me feel more confident in caring for healthcare clients.
1.33%
0.00%
0.00%
2.67%
0.00%
0.00%
5.33%
5.33%
1.33%
0.00%
1.33%
2.67%
0.00%
4.00%
100.00%
98.67%
94.67%
94.67%
98.67%
98.67%
97.33%
97.33%
100.00%
93.33%


Have a free text comment section on the evaluation. Actual student comments…….
I really enjoy SIMs and I always learn a lot from them. I wish we had more and I will continue to learn and feel more comfortable when entering a patient's room.
I always learn things that I know I won’t forget. It is good to have these simulations because we don't always come across some of these situations when we are actually in clinicals. Because of these simulations, I know i will be prepared when I come across the same problems.
. T he feedback in the debriefing session was very informative without being condemning. Good job !


Short answer --- IT’S WORTH IT !!

To the instructor

To the students

To the future employer

To the client

Contact information
Joanie Selman, MSN, RN selmand@sfasu.edu
936-674-7896
DeWitt School of Nursing
Stephen F. Austin State University
Nacogdoches, Texas